There is growing recognition among researchers that the psychosocial variables associated with doctor-patient relationship and communication hold significant insight for understanding the development of disease and disability. However, there have been virtually no empirically based studies of communication. This proposal suggests an observational study of communication between elderly patients and their providers during routine medical care in which the characteristics of the encounter may be described and analyzed. Tape recordings of 125 provider-patient encounters will be collected and analyzed during routing delivery of care at the Southeast Community Health Center. Five providers (4 physicians and 1 nurse practitioner) will take part in the study. Analysis of the tapes will be structured by adaption and modification of a process analysis scheme developed specifically for the therapuetic encounter. The scheme addresses the following aspects of interaction: 1) the interaction content; 2) interaction structure; and 3) affective context of interaction. In addition, modifications of the schemes will allow investigation of the role assumed by a third party (usually an adult child or caretaker) participating in the doctor-patient dialogue. Finally, a number of correlates of communication will be explored in post visit interview such as patient recall of information transmitted during the encounter, satisfaction with care and the provider's interpersonal competence, intention to comply with suggested regimens, intentions to comply with preventive health advice, and perception of ability to self care. Correlates of communication from the provider's vantage will also be explored through post visit questionnaire. The significance of the proposal is underlined by its unique contribution to the field by way of an empirical description of elderly pateint-provider interaction. Further, the study may contribute to the identiofication of communication problems which may be remedied by patient or provider interventions. Finally, this data may contribute to a better understanding of the relationship between the communication of the medical visit and psychosocial factors ultimately related to maintenance of functioning disease prevention and limitation of disability.